Level of care and benefit
Confirm the program, payer and authorization requirements for the actual service. Do not assume one payer’s program coverage applies to another.
Substance Use & IOP BILLING SUPPORT
Align the level of care, authorization and billing period.
Substance use programs and intensive outpatient services can involve multiple visits, disciplines and payer requirements. The operational record needs to explain what was authorized and delivered.
WHERE THE WORK GETS STUCK
The claim starts before submission.
Attendance records, daily services and program authorizations can be maintained in different places. Billing without a connected view makes it harder to resolve level of care or frequency questions.
SPECIFIC OPERATIONAL CHECKS
What we connect in the workflow.
Attendance and services
Reconcile attendance and documented services before a billing period is submitted. Clarify missing records with the responsible clinical team.
Dates, frequency and follow ups
Track authorization periods, claim frequency and payer requests. Use the appropriate billing structure for the program and setting.
ILLUSTRATIVE CODE REFERENCES
Small details.
Different claim questions.
Examples for understanding the workflow.
Code selection follows the actual service.
| Code | Example service | Operational check |
|---|---|---|
| H0015 | Intensive outpatient service example | Use depends on the program, payer and service requirements. |
| G0410 | Group psychotherapy in specified programs | Check the program and setting requirements before billing. |
Illustrative CPT, HCPCS or other billing references, not coding instructions or coverage promises. Current code sets, documentation, payer policy and date of service control the correct claim. Review the relevant billing reference
WHAT YOUR PRACTICE RECEIVES
Clear exceptions.
A visible next action.
A program authorization view, attendance-to-claim reconciliation and a dated queue for payer questions.
- A named owner and agreed communication plan
- Enrollment and payment setup gaps included in the review
- Written scope before access or service begins
CLAIM VOLUME AND SCOPE
Use your workload, not an industry guess.
Program days, attendance, payer billing rules and service mix determine the claim workload; scheduled capacity alone is not a billing estimate.
Billing is quoted as a percentage of monthly collections. Provider count, workflows and historical outstanding work help define the responsibilities included in your agreement.
See Billing & RCMBEFORE WE BEGIN
Agree on the details that affect delivery.
We map your payer mix, systems and the three workflow checks above, then agree on the records and scope needed. No practice information is required before the mutual agreement is signed.
No. We identify gaps and possible next actions. Coverage, records, filing windows and payer decisions determine whether a claim can be corrected or paid.
After the agreement and a BAA, we arrange a secure handover with approved access. Please do not send patient information through public website forms or regular email.
CONNECT THE DETAILS
Start with your practice, not a generic proposal.
A Free Practice Review connects billing, credentialing, enrollment and payment setup. We agree on scope first, with a signed agreement and BAA before practice data moves.